Tattooing and body piercing are now worldwide fashion crazes. The health risks associated with these procedures are as yet unclear. This article examines the prevalence of body decoration and the associated health risks within the Australian population using a random sample survey of individuals aged 14 years and over, collected between June and September 1998 (n = 10,030). The results show that one in 10 people have had a tattoo at some point in their lives and 8 per cent some form of body piercing, excluding ear piercing. Men are more likely than women to report tattooing, while females are more likely to report body and ear piercing. Some 10 per cent of respondents report drinking alcohol or using other drugs when the procedures were undertaken. The prevalence of tattooing and body piercing is considerably higher among injecting drug users. Although the rates of transmission of bloodborne disease due to body decoration are believed to be low, the strong association with youth and with injecting drug use suggests considerable potential for transmission.